Abstract
Pregnant and lactating women (PLW) represent a particular population subset with increased susceptibility for COVID-19 morbidity and mortality, even though the evidence about the safety and efficacy of COVID-19 vaccines was delayed due to their initial exclusion from development trials. This unclear situation could have led to increased COVID-19 vaccine hesitancy levels among PLW; therefore, this study aimed to evaluate the attitudes of Czech PLW towards COVID-19 vaccines and the determinants of their attitudes. An analytical cross-sectional survey-based study was carried out in the University Hospital Brno (South Moravia, Czechia) between August and October 2021. The study utilised a self-administered questionnaire (SAQ) adapted from previous instruments used for the same purpose. The SAQ included closed-ended items covering demographic characteristics, clinical and obstetric characteristics, attitudes towards COVID-19 vaccination, and potential psychosocial predictors of vaccine acceptance. Out of the 362 included participants, 278 were pregnant (PW) and 84 were lactating women (LW). The overall COVID-19 vaccine acceptance (immediate and delayed) level was substantially high (70.2%), with a significant difference between PW (76.6%) and LW (48.8%). Out of the 70.2% who agreed to receive the vaccine, 3.6% indicated immediate acceptance, and 66.6% indicated delayed acceptance. Only 13.3% of the participants indicated their acceptance of their physician’s vaccination recommendation during pregnancy or while lactating, and 62.2% were against it. Our results agreed with the recent studies that revealed that PW tended to have a high level of COVID-19 vaccine acceptance, and they were also inclined to resist professional recommendations because they predominantly preferred to delay their vaccination. The pregnancy trimester, education level, employment status, and previous live births were significant determinants for COVID-19 vaccine acceptance. The most commonly preferred vaccine type was mRNA-based vaccines, followed by viral vector-based and inactivated virus vaccines. The first top priority of PLW was vaccine safety for their children, followed by vaccine safety for the PLW and vaccine effectiveness. Regarding psychosocial predictors, media/social media, trust in the government, the pharmaceutical industry, and healthcare professionals, partners, and a positive risk-benefit ratio were significant promoters for COVID-19 vaccine acceptance. Findings from this study suggest that promotional interventions targeting PLW should use web platforms and focus on vaccine safety evidence, the expected benefits of vaccines and potential harms of the infection.
Highlights
The pregnancy and lactation periods are special times when susceptibility to morbidity and mortality for certain diseases increase [1]
Pregnant and lactating women (PLW) represent a particular population subset with increased susceptibility for COVID-19 morbidity and mortality, even though the evidence about the safety and efficacy of COVID-19 vaccines was delayed due to their initial exclusion from development trials. This unclear situation could have led to increased COVID-19 vaccine hesitancy levels among pregnant and lactating women (PLW); this study aimed to evaluate the attitudes of Czech PLW towards COVID-19 vaccines and the determinants of their attitudes
The aim of this study was to evaluate the attitudes of PLW in Czechia towards COVID-19 vaccination, as the primary objective was to estimate the prevalence of COVID-19 vaccine acceptance, while the secondary objective was to explore the potential determinants of COVID-19 vaccine acceptance
Summary
The pregnancy and lactation periods are special times when susceptibility to morbidity and mortality for certain diseases increase [1]. Considering the COVID-19 disease, it has been shown that pregnant women (PW) are more likely to show symptoms, be hospitalised in intensive care units, and need ventilators compared to non-pregnant women (NPW) of the same age [2,3] For this reason, it is of practical value that vaccination, which is the most effective method of coping with the current pandemic, is recommended for the population of pregnant and lactating women (PLW). One can put forward that making decisions during pregnancy leads to changes in the priorities, concerns and risk perception of PLW compared to other members of the society [6] In this context, it is imperative to investigate the factors that push this particular group to abstain from vaccination, achieving the success of vaccination programs [7]
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